All providers at Santa Monica Dermatology Medical Group are experienced in the treatment of acne, psoriasis, eczema, rashes, hair loss, nail disease and all forms of skin cancer.

Skin Cancers

Skin cancer is the most common form of human cancers, affecting more than one million Americans every year. One in five Americans will develop skin cancer at some point in their lives. In fact, skin cancer is more common than all other types of cancer combined. Skin cancers are generally curable if caught early. However, people who have had skin cancer are at a higher risk of developing a new skin cancer, which is why regular self-examination and doctor visits are imperative.

The vast majority of skin cancers are composed of three different types: Basal cell carcinoma, Squamous cell carcinoma and Melanoma.

Basal Cell Carcinoma

This is the most common form of skin cancer. Basal cells reside in the deepest layer of the epidermis, along with hair follicles and sweat ducts. When a person is overexposed to UVB radiation, it damages the body's natural repair system, which causes basal cell carcinomas to grow. These tend to be slow-growing tumors and rarely metastasize (spread). Basal cell carcinomas can present in a number of different ways:

Despite the different appearances of the cancer, they all tend to bleed with little or no cause. Eighty-five percent of basal cell carcinomas occur on the face and neck since these are areas that are most exposed to the sun.

Risk factors for basal cell carcinoma include having fair skin, sun exposure, age (most skin cancers occur after age 50), exposure to ultraviolet radiation (as in tanning beds) and therapeutic radiation given to treat an unrelated health issue.

Diagnosing Basal cell carcinoma requires a biopsy using a small blade to obtain a sample of the lesion for pathologic testing. (deleted blurb about incisional vs excisional biopsies)

The optimal treatment for any given basal cell carcinoma is determined by the tumor’s location, size, and subtype. Some basal cell carcinomas are considered low-risk and others are considered high-risk for recurrence. Treatment options include:

Mohs Micrographic Surgery — The preferred method for tumors that are high-risk or in cosmetically sensitive locations, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor. At the same time, Mohs provides the highest cure rate of all methods, nearly 100% in most cases. Read More...

Curettage and Desiccation — This treatment involves using a small metal instrument called a curette to scrape out the tumor, along with the application of electric cautery to kill off any remaining cancer cells. It is used for low-risk, non-aggressive types of skin cancer. The cure rate is not as high as surgery or radiation.

Surgical Excision — With this treatment the tumor is surgically excised with appropriate margins onf normal skin, depending on the aggressiveness of the tumor. The specimen is sent to pathology to ensure the tumor has been completely removed.

Radiation Therapy — Radiation therapy is a nonsurgical treatment that offers good cure rates. It requires multiple visits to a radiation oncologist over the period of a couple weeks. Radiation is used as second-line when surgery is not a good option.

Squamous Cell Carcinoma

Squamous cells are found in the upper layer (the surface) of the epidermis. They look like fish scales under a microscope and present as a crusted or scaly patch of skin with an inflamed, red base. They are often tender to the touch. It is estimated that 250,000 new cases of squamous cell carcinoma are diagnosed annually, and that 2,500 of them result in death.

Squamous cell carcinoma can develop anywhere, including inside the mouth and on the genitalia. It most frequently appears on the scalp, face, ears and back of hands. Squamous cell carcinoma tends to develop among fair-skinned, middle-aged and elderly people who have a history of sun exposure. In some cases, it evolves from actinic keratoses, dry scaly lesions that can be flesh-colored, reddish-brown or yellow black, and which appear on skin that is rough or leathery. Actinic keratoses spots are considered to be precancerous.

The optimal treatment for any given squamous cell carcinoma is determined by the tumor’s location, size, and subtype. Some squamous cell carcinomas are considered low-risk and others are considered high-risk for recurrence. A minority of squamous cell carcinomas will metastasize (spread), and fewer still will cause death. Treatment options include:

Mohs Micrographic Surgery — The preferred method for tumors that are high-risk or in cosmetically sensitive locations, Mohs Micrographic Surgery combines removal of cancerous tissue with microscopic review while the surgery takes place. By mapping the diseased tissue layer by layer, less healthy skin is damaged when removing the tumor. At the same time, Mohs provides the highest cure rate of all methods, nearly 100% in most cases. Read More...

Curettage and Desiccation — This treatment involves using a small metal instrument called a curette to scrape out the tumor, along with the application of electric cautery to kill off any remaining cancer cells. It is used for low-risk, non-aggressive types of skin cancer. The cure rate is not as high as surgery or radiation.

Surgical Excision — With this treatment the tumor is surgically excised with appropriate margins onf normal skin, depending on the aggressiveness of the tumor. The specimen is sent to pathology to ensure the tumor has been completely removed.

Radiation Therapy — Radiation therapy is a nonsurgical treatment that offers good cure rates. It requires multiple visits to a radiation oncologist over the period of a couple weeks. Radiation is used as second-line when surgery is not a good option.

Melanoma

While Melanoma is the least common type of skin cancer, it is by far the most dangerous. It is the most common form of cancer among young adults age 25 to 29. Melanocytes are cells found in the bottom layer of the epidermis. These cells produce melanin, the substance responsible for skin pigmentation. That's why Melanomas often present as dark brown or black spots on the skin. Melanomas spread rapidly to internal organs and the lymph system, making them quite dangerous. Early detection is critical for curing this skin cancer.

Melanomas look like moles and often do grow inside existing moles. That's why it is important for people to conduct regular self-examinations of their skin in order to detect any potential skin cancer early, when it is treatable. Most melanomas are caused by overexposure to the sun beginning in childhood. This cancer also runs in families.

Prevention

Staying out of the sun during peak hours (between 10 a.m. and 4 p.m.).

Covering up the arms and legs with protective clothing.

Wearing a wide-brimmed hat and sunglasses.

Using sunscreens year round with a SPF of 30 or greater and sunblocks that work on both UVA and UVB rays. Look for products that use the term "broad spectrum."

Checking your skin monthly and contacting your dermatologist if you notice any changes.

Getting regular skin examinations. It is advised that adults over 40 get an annual exam with a dermatologist.

Acne

Acne is the most frequent skin condition seen by medical professionals. It consists of pimples that appear on the face, back and chest. About 80% of adolescents have some form of acne and about 5% of adults experience acne. In normal skin, oil glands under the skin, known as sebaceous glands, produce an oily substance called sebum. Read More »

Moles (Nevi)

Moles are brown or black growths, usually round or oval, that can appear anywhere on the skin. They can be rough or smooth, flat or raised, single or in multiples. They occur when cells that are responsible for skin pigmentation, known as melanocytes, grow in clusters instead of being spread out across the skin. Generally, moles are less than one-quarter inch in size. Most moles appear by the age of 20, although some moles may appear later in life. Read More »

Psoriasis

Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis. A good resource for more information regardiing Psoriasis can be found at http://www.psoriasis.org/Read More »

Rashes

"Rash" is a general term for a wide variety of skin conditions. A rash refers to a change that affects the skin and usually appears as a red patch or small bumps or blisters on the skin. The majority of rashes are harmless and can be treated effectively with over-the-counter anti-itch creams, antihistamines and moisturizing lotions. Read More »

Rosacea

Rosacea is a chronic skin condition that causes facial redness, acne-like pimples, visible small blood vessels on the face, swelling and/or watery, irritated eyes. This inflammation of the face can affect the cheeks, nose, chin, forehead or eyelids. More than 14 million Americans suffer from rosacea. It is not contagious, but there is some evidence to suggest that it is inherited. There is no known cause or cure for rosacea. There is also no link between rosacea and cancer. A good resource for information regarding Rosacea can be found at http://www.rosacea.org/index.phpRead More »

Warts

Warts are small, harmless growths that appear most frequently on the hands and feet. Sometimes they look flat and smooth, other times they have a dome-shaped or cauliflower-like appearance. Warts can be surrounded by skin that is either lighter or darker. Warts are caused by different forms of Human Papilloma Virus (HPV). They occur in people of all ages and can spread from person-to-person and from one part of the body to another. Warts are benign (noncancerous) and generally painless. Read More »